Bradycardia Algorithm Video

Step one, assess for bradycardia, which is generally a pulse below 50. Next, try to figure out what’s causing this bradycardia. Ask the patient, “What’s your normal heart rate?” If they’re an athlete, it may normally be low. Again, we’re treating the patient, not the rhythm. Quickly get a history, what medications they’re taking, pertinent past medical history. Next, supportive care. Get your patient on some oxygen. Remember, we’re trying to achieve an SPO2 of 94% to 95% (you might see that on a test). Get your IV. Get your 12-lead as long as it doesn’t delay care, but start your supportive care. Next, is there persistent bradycardia? We’re looking, again, for signs of shock: hypotension, altered mental status, poor perfusion. If the patient doesn’t have these, you’re fine; monitor your patient. If, yes, the patient is showing signs of shock, we’re moving right into drugs. First drug up: atropine sulfate 0.5 mg IV push, rapid. If the atropine is ineffective, consider a dopamine infusion or going right to transcutaneous pacing. Next, consider an expert consult. Get a cardiologist involved with this patient very quickly so we can determine the cause of the bradycardia.